Water quality and safety are vital to the ecological environment, social development, and ecological susceptibility. The extensive use and continuous discharge of antibiotics have caused serious water pollution; antibiotics are widely found in freshwater, drinking water, and reservoirs; and this pollution has become a common phenomenon and challenge in global water ecosystems, as water polluted by antibiotics poses serious risks to human health and the ecological environment. Therefore, the antibiotic content in water should be identified, monitored, and eliminated. Nevertheless, there is no single method that can detect all different types of antibiotics, so various techniques are often combined to produce reliable results. This review summarizes the sources of antibiotic pollution in water, covering three main aspects: (1) wastewater discharges from domestic sewage, (2) medical wastewater, and (3) animal physiology and aquaculture. The existing analytical techniques, including extraction techniques, conventional detection methods, and biosensors, are reviewed. The electrochemical biosensors have become a research hotspot in recent years because of their rapid detection, high efficiency, and portability, and the use of nanoparticles contributes to these outstanding qualities. Additionally, the comprehensive quality evaluation of various detection methods, including the linear detection range, detection limit (LOD), and recovery rate, is discussed, and the future of this research field is also prospected.